FamilyCare beneficiaries laud governor's conviction

Tuesday

Dec 25, 2007 at 12:01 AMDec 25, 2007 at 7:24 PM

Recently, the entire Bloomfield family was able to get affordable, comprehensive health insurance — thanks to Gov. Rod Blagojevich’s willingness to defy state lawmakers and expand state-subsidized coverage for the poor and middle class.

Dean Olsen

It will take Mary and Thomas Bloomfield several years to pay off the $3,000 bill they received when emergency room doctors at Carlinville Area Hospital diagnosed their 12-year-old son with a urinary-tract infection.

Bradford Bloomfield was uninsured at the time, as were his 8-year-old brother, Ryan, and the boys’ parents. So the Bloomfields are chipping away at the hospital bill at a rate of $100 a month.

The next emergency room visit should be easier to handle. Recently, the entire Bloomfield family was able to get affordable, comprehensive health insurance — thanks to Gov. Rod Blagojevich’s willingness to defy state lawmakers and expand state-subsidized coverage for the poor and middle class.

Debate continues about whether the Democratic governor’s action was legal and whether the move will be a wise investment by state government.

“It’s appropriate for us to partner with families of low and moderate income,” said Jerome Stermer, president of Chicago-based Voices for Illinois Children, which supports the governor’s decision.

But state Sen. Christine Radogno, R-Lemont, said the governor’s plans amount to “a very broad expansion that has the potential to draw people off the rolls of private insurance. I think that government should take a back seat to the private sector.”

Mary “Cissy” Bloomfield and her husband originally picked up a brochure for the state’s All Kids program while in the Carlinville hospital’s ER. They then applied for and received health coverage for the boys through that program, at a total premium of $80 a month.

The couple didn’t expect a letter from the Illinois Department of Healthcare and Family Services saying that they, too, were eligible for subsidized coverage — through the state’s FamilyCare program for uninsured parents — for an additional $160 a month.

The couple accepted the offer, Mary said, because they didn’t want to risk another big bill for some future medical problem.

“That’s always in the back of anybody’s mind,” she said. “Bradford’s illness brought it into reality.”

With a combined annual income of about $50,000, the Bloomfields, who live in Hettick, 40 miles southwest of Springfield in Macoupin County, previously earned too much money to qualify for FamilyCare.

Mary, 35, a registered nurse, earns $35,000 a year at a Carlinville nursing home. Thomas, 36, who runs a lawn-care business, makes about $15,000.

The previous cutoff for FamilyCare was 185 percent of the federal poverty level, or $38,203 for a family of four. That changed this fall, when the governor used what he sees as his executive authority to expand the income guidelines for FamilyCare.

The upper limit to qualify for FamilyCare now stands at 400 percent of the poverty level, or $82,600 for a family of four. That level makes Illinois the most generous state in the nation when it comes to serving uninsured parents, according to Jennifer Tolbert of the Kaiser Family Foundation.

Several hundred parents have signed up. Blagojevich’s move, currently facing a legal challenge in Cook County, is expected to cost the state $43 million this fiscal year.

The FamilyCare expansion is part of $463 million in health-care initiatives the governor plans to put in place without approval from the Illinois General Assembly.

Mary Bloomfield said she is glad Blagojevich is willing to take some flak for the benefit of her and other uninsured parents.

“I’d stand behind him 100 percent,” she said.

FamilyCare began in 2002 under Republican Gov. George Ryan.

The program now covers 547,000 parents and cost $1.28 billion last fiscal year, with $685 million of the total coming from the federal government, according to Healthcare and Family Services.

Blagojevich, who has made expansion of health-care coverage a top priority of his second term, included the FamilyCare expansion in his massive health coverage proposal earlier this year.

But lawmakers never took a vote on that proposal, which was called Illinois Covered, because of disagreement over the way it was to be funded: a gross-receipts tax on businesses and an additional payroll tax on employers that offer little or no health coverage to workers.

The governor’s aides said he plans to ask the General Assembly again to pass the payroll tax this spring.

But Blagojevich didn’t want to wait for lawmakers, according to deputy governor Sheila Nix.

“They don’t seem anxious to act,” she said. “We could be waiting a very long time.”

Nix said FamilyCare is “designed to help working families buy affordable insurance. Many of these parents are in families where they work, but their employers don’t provide insurance, and the private market is either unavailable to them or unaffordable to them, or a combination of both.”

Before the Bloomfields’ coverage started Dec. 1, the family had been uninsured for more than two years. They used to have insurance through Thomas’ former job as a cross-country truck driver and then as a stocker at Carlinville’s Wal-Mart. Mary said the monthly family premiums were less than $300.

But Thomas has bipolar disorder, and his wife said emotional outbursts related to his condition got him fired in October 2005. After he lost the Wal-Mart job, the family couldn’t afford the $950 a month that coverage through Mary Bloomfield’s employer would have cost. And that insurance wouldn’t have paid for anything related to her sons’ attention-deficit hyperactivity disorder for the first 18 months anyway.

A private policy would have cost at least $400 to $500 a month — still unaffordable, she said.

But for a total of $240 monthly for All Kids and FamilyCare, the Bloomfield family has no co-pay for doctor visits for the children and only a few dollars when the parents need care.

The Bloomfields used to pay $120 per child each month for the boys’ ADHD medicine. With All Kids, each prescription costs $7. The parents’ co-pays are nothing for generics and $3 for brand-name drugs.

Mary and Thomas Bloomfield said there is no shame in getting coverage from the tax-supported programs.

“Insurance is just untouchable anymore,” Thomas said.

Mary added: “We still have to pay for things. I’ve worked for 20 years, paying taxes, so right now I don’t feel bad. I feel they can help me in my time of need.”

Dean Olsen can be reached at 788-1543 or dean.olsen@sj-r.com.

SIDEBAR

By DEAN OLSEN

STAFF WRITER

SPRINGFIELD -- Gov. Rod Blagojevich’s administration, state lawmakers and other observers disagree whether he should have expanded the FamilyCare program to cover parents earning up to four times the federal poverty level.

“It’s difficult to justify taxpayers basically subsidizing families that are making $80,000 a year, particularly when some of the very families doing the subsidization are making $40,000 a year,” says state Sen. Christine Radogno, R-Lemont.

Blagojevich aide Abby Ottenhoff disagrees.

For one thing, the program isn’t free for middle-income families, she said.

“The families who participate pay premiums, and the higher your income, the higher your premium, so the state subsidy for people who have higher incomes is very, very minimal,” Ottenhoff said.

Families who are near the $80,000 income level in the FamilyCare program “either are unable to get coverage on the private market right now because of a pre-existing condition, so they’re just uninsurable,” Ottenhoff said. “Or they don’t have access to employer-sponsored coverage and would have to get it on the private market, which could mean having to spend up to a quarter of their family income on health premiums.”

She said the average premium for family health insurance is $15,000 a year.

“After health care, you can’t really afford to pay a mortgage or normal expenses for kids,” she said.

But Radogno, a former hospital social worker, said she favors a more focused approach to the problems faced by the uninsured.

“How does one individual define that they can or cannot afford something?” she asked. “That’s sort of a variable standard, and that’s probably a discussion as policy-makers we need to have. Government is probably not the best entity to mediate everyone’s circumstances.”

State Reps. Rich Brauer, R-Petersburg, and Gary Hannig, D-Litchfield, also said health-care expansion is too important to do without General Assembly support.

“This needs to go through the process and have a fair debate,” Brauer said.

Hannig and Rep. David Leitch, R-Peoria, said the governor’s health-care expansion could add to the state’s debts and become part of a financial crisis that could end up denying citizens a variety of state services.

“Clearly there’s a potential for some good” with Blagojevich’s FamilyCare expansion, Leitch said. “But to expand this without being able to pay for it now … is just the height of irresponsibility.”

Jerome Stermer, president of Chicago-based Voices for Illinois Children, said his group is glad the expansion is happening, but concerned that resentment generated by the governor’s methods could jeopardize future funding of FamilyCare.

Dean Olsen can be reached at (217) 788-1543 or dean.olsen@sj-r.com.

FACTS BOX

FAMILYCARE

WHAT: All uninsured parents or guardians of children enrolled in state health-care programs are eligible for FamilyCare if their income is less than four times the federal poverty level, or $82,600 for a family of four.

OTHER DETAILS: Undocumented immigrants are allowed in the state’s All Kids program but not in FamilyCare. Applicants can’t be denied or face increased rates because of pre-existing conditions. Parents must have been uninsured for at least one year, with some exceptions, such as being laid off from a job or other hardships.

SUBSIDIZED HEALTH CARE: 2.2 million men, women and children in Illinois receive some form of subsidized health coverage from the state through programs that include Medicaid, All Kids and FamilyCare. That coverage cost $8.2 billion in fiscal 2007.

TOTAL UNINSURED ILLINOISANS: 1.7 million people, representing 13.6 percent of the population, or at least one out of every eight people.

Sources: Illinois Department of Healthcare and Family Services and U.S. Census Bureau

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